Friday, March 16, 2012

Gd-willing, I'll present a shiur on Monday night regarding the conflicts a doctor faces between taking care of patients and managing his other mitzvah responsibilities. Obviously, doctors who are taking care of patients are engaged in great service of Gd as well as Man, but how should a doctor find balance between medical mitzvot and other mitzvot?

Here are the specific questions I hope to address; feedback would be most welcome-

1. How do I choose between religious observance and non-critical patient care? Is it better to keep patients in a waiting room while praying minchah, or am I exempt from prayer? May I recite abbreviated prayers, or pray while driving? Do we differentiate for women and men?

2. How do I manage a Passover Seder while on call? What sections should be prioritized?

3. I know that I will need to see patients in the hospital on Shabbat, Yom Tov or Yom Kippur in the coming weeks. I will do my best to do so according to Jewish law regardless of which day I am in the hospital, but how do I prioritize between these special days?

UPDATE: Here is the source sheet I intend to use-

A core principle: One
who is involved in a mitzvah is exempt from further mitzvot

Gemara: How do we know this?
The sages taught, "'When you lie down in your house' excludes one who is
involved in a mitzvah"…

But do we learn [this lesson]
from this source? It is deduced from that: "'And there were men who were
impure from contact with the dead' – Who were those men? The bearers of
Joseph's casket, per R' Yosi haGlili. R' Akiva said they were Mishael and
Eltzafan, who were involved with Nadav and Avihu. R' Yitzchak said the bearers
of Joseph's casket could have purified themselves, and Mishael and Eltzafan
could have purified themselves; rather, these were people involved in a body
which had no one else…"!

We need both cases. From the
Pesach case I would have said the exemption is limited, because they became
impure before the time for Pesach, but where the time for Shema has arrived one
would not be exempt [if he began a different mitzvah]. And from the Shema case,
I would have said one is exempt only because there is no harsh penalty
involved, like kareit, but in a case [like Pesach] involving kareit this
would not be so. Both are necessary…

We have learned, "R'
Chanania ben Akavyah said: Those who write Torah scrolls, tefillin and mezuzot,
and their merchants, and their merchants' merchants, and all who do Heavenly
work – which includes techelet merchants – are exempt from Shema, the amidah
and tefillin and all biblical mitzvot, as R' Yosi haGlili said, 'One who is
involved in a mitzvah is exempt from another mitzvah.'"

We have learned, "Those
who travel by day are exempt from Succah by day, and are obligated at night. Those
who travel at night are exempt from Succah at night, and are obligated by day.
Those who travel at both day and night are exempt from Succah day and night.
Those who travel for a mitzvah are exempt during day and night."

Tosafot suggested that one is exempt only if
fulfilling Succah would cause him to be unable to fulfill his other mitzvah. The
gemara mentions that Rav Chisda and Rabbah bar Rav Huna travelled to the Exilarch's
house for the Shabbat of the holiday and slept along the shore in Sura, saying
they were en route to a mitzvah and therefore exempt; Tosafot says that this is
only where involvement in Succah would have caused them to be delinquent from
their mitzvah. This does not appear correct to me, though; the language does
not indicate that.

How does one recite [the wayfarer's prayer]? Rav
Chisda said: While standing. Rav Sheshet said: Even while travelling.

Rav Chisda and Rav Sheshet were travelling, and Rav
Chisda halted to pray. Rav Sheshet said to his servant, "What is Rav
Sheshet doing?" He said, "He has halted, and he is praying." Rav
Sheshet said, "Halt me, too, and I will pray; given the chance to be good,
do not be called bad."

Those who write Torah
scrolls, tefillin and mezuzot stop for Shema and not for the amidah. R' Chanina
ben Akaviah said: Just as they stop for Shema, they stop for the amidah,
tefillin, and all other biblical mitzvot.

R' Yosef Karo: Those who write Torah scrolls, tefillin and
mezuzot, and their merchants, and their merchants' merchants, and all who do
Heavenly work are exempt from tefillin all day, other than during Shema and the
amidah.

R' Moshe Isserles: If they need to do their work during Shema and the
amidah, they are exempt from Shema, the amidah and tefillin, for one who is
involved in a mitzvah is exempt from other mitzvot if he would need to strain to
fulfill the other mitzvah. If he can fulfill both without strain, though, then
he should fulfill both.

Two possible limitations

6.Rabbeinu Nisim (14th
century Spain), Succah 11a ואיכא

ודאי בשעה שהאבדה משומרת בתיבתו לא מפטר

Certainly, when the lost object is guarded in his safe
then he is not exempt.

All are obligated to give tzedakah, but there is neither
obligation nor mitzvah for any particular person to be a tzedakah collector.
Were there such a mitzvah, all Israel would be obligated to become collectors.

8.Rashi to Succah 26a

תגריהן
- הלוקחין מהן כדי למכור ולהמציאן לצריך להם

"Their merchants" – Who
purchase from the scribes, to sell them and make them available to those who
need them.

It sounds as though one who sells them for profit is
not called "involved in a mitzvah". This requires examination, for
Nedarim 33 sounds like one who returns a lost object is called"involved in
a mitzvah" even if he is paid! Perhaps that is different because he is
only paid for time lost from work. Alternatively, his main intent is to return
the lost object; merchants intend to profit, primarily.

R' Yitzchak Zylbershtein wrote: Even though doctors
and nurses are paid for their work, still, they are like people returning lost
objects – and there is no greater restorer of a lost object! Therefore, since
he does not think about profit at all while working, but is only involved in
healing the patient, and his care, or that of a nurse, is the mitzvah itself,
he has the status of one who is involved in a mitzvah.

Commerce in tefillin is never considered a mitzvah.
Even if selling it to someone who needed tefillin would be considered
'involvement in a mitzvah', still, when the merchant buys them in order to sell
them he is not actively involved in a mitzvah with that action.

12.R' Avraham Gombiner, Magen
Avraham 93:5

וא"צ
להתפלל מנחה שתים כיון דבשעת חובתו היה פטור מן הדין

He need not recite minchah twice; during the
obligation, he was legally exempt.

I have heard from my master R' Yehoshua Neuwirth that
a doctor is exempt from prayer not only when he is examining or treating a
patient – even without danger to life – but even when he is writing in the
patient's record, and even when he is writing release documents. All of this is
"involvement in the mitzvah."

2 comments:

I gave a yahrtzeit shiur this shabbat concerning volunteerism which focused on responsibility to oneself vs. to the kahal. Bottom line imvho is there is no "magic" halachic answer to the kind of questions you raise and to trade offs involved in living the vida dialectic. Rather one must hopefully be blessed with role models at an early age, and seek them out in later years, to try to internalize an halachic compass that will guide one between conflicting goods!KTJoel Rich